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Minimally cardiac surgery

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https://www.readbyqxmd.com/read/28805824/flexible-shape-memory-scaffold-for-minimally-invasive-delivery-of-functional-tissues
#1
Miles Montgomery, Samad Ahadian, Locke Davenport Huyer, Mauro Lo Rito, Robert A Civitarese, Rachel D Vanderlaan, Jun Wu, Lewis A Reis, Abdul Momen, Saeed Akbari, Aric Pahnke, Ren-Ke Li, Christopher A Caldarone, Milica Radisic
Despite great progress in engineering functional tissues for organ repair, including the heart, an invasive surgical approach is still required for their implantation. Here, we designed an elastic and microfabricated scaffold using a biodegradable polymer (poly(octamethylene maleate (anhydride) citrate)) for functional tissue delivery via injection. The scaffold's shape memory was due to the microfabricated lattice design. Scaffolds and cardiac patches (1 cm × 1 cm) were delivered through an orifice as small as 1 mm, recovering their initial shape following injection without affecting cardiomyocyte viability and function...
August 14, 2017: Nature Materials
https://www.readbyqxmd.com/read/28796646/defining-benchmarks-for-transthoracic-esophagectomy-a-multicenter-analysis-of-total-minimally-invasive-esophagectomy-in-low-risk-patients
#2
Henner M Schmidt, Susanne S Gisbertz, Johnny Moons, Ioannis Rouvelas, Juha Kauppi, Andrew Brown, Emanuele Asti, Misha Luyer, Sjoerd M Lagarde, Felix Berlth, Annouck Philippron, Christiane Bruns, Arnulf Hölscher, Paul M Schneider, Dimitri A Raptis, Mark I van Berge Henegouwen, Philippe Nafteux, Magnus Nilsson, Jari Räsanen, Francesco Palazzo, Ernest Rosato, Stuart Mercer, Luigi Bonavina, Grard Nieuwenhuijzen, Bas P L Wijnhoven, Wolfgang Schröder, Piet Pattyn, Peter P Grimminger, Christian A Gutschow
OBJECTIVE: To define "best possible" outcomes in total minimally invasive transthoracic esophagectomy (ttMIE). BACKGROUND: TtMIE, performed by experts in patients with low comorbidity, may serve as a benchmark procedure for esophagectomy. PATIENTS AND METHODS: From a cohort of 1057 ttMIE, performed over a 5-year period in 13 high-volume centers for esophageal surgery, we selected a study group of 334 patients (31.6%) that fulfilled criteria of low comorbidity (American Society of Anesthesiologists score ≤2, WHO/ECOG score ≤1, age ≤65 years, body mass index 19-29 kg/m)...
August 7, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28790281/-perioperative-management-for-prevention-of-cardiac-complications-in-general-thoracic-surgery
#3
Terumoto Koike, Masanori Tsuchida
For general thoracic surgeons, perioperative management for prevention of cardiac complications is important because patients undergoing general thoracic surgery often have risk factors for cardiac disease. Sever cardiac failure should be detected and treated prior to surgery, and coronary artery may be examined in patients with risk factors for ischemic heart disease. Pulmonary resection sometimes causes right-sided heart failure due to reducing pulmonary vascular bed. In high-risk patients for rightsided heart failure, pulmonary artery pressure monitoring by right heart catheterization should be considered in addition to blood pressure and central venous pressure monitoring, and precise fluid management is required...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28790271/-chronic-kidney-disease-tips-and-pitfall-of-perioperative-management
#4
Satsuki Fukushima, Tomoyuki Fujita, Junjiro Kobayashi
Chronic kidney disease(CKD) is an important risk factor of open heart surgery. In addition, worsening of kidney function after the surgery leads to poor prognosis long-term. It is therefore crucial to protect the kidney function by intensive perioperative management in open heart surgery. In the patients having stage 3-4 CKD, mean arterial pressure needs to be higher than 70 mmHg and cardiac index needs to be greater than 2.4 intraoperatively and postoperatively. Continuous right heart monitoring by Swan-Ganz catheter is useful for this purpose...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28771400/single-incision-laparoscopic-intragastric-surgery-for-gastric-submucosal-tumor-located-adjacent-to-esophagogastric-junction-report-of-four-cases
#5
Shinsuke Katsuyama, Kiyokazu Nakajima, Yukinori Kurokawa, Tsuyoshi Takahashi, Yasuhiro Miyazaki, Tomoki Makino, Makoto Yamasaki, Shuji Takiguchi, Masaki Mori, Yuichiro Doki
BACKGROUND: Laparoscopic local gastric resection has become the standard form of surgery for gastric submucosal tumors (SMTs) and is currently being actively selected for these cases. However, total gastrectomy or proximal gastrectomy is performed when tumors are adjacent to the cardia of stomach. Unfortunately, these procedures are highly invasive and can cause marked decreases in activities of daily living. We perform a single-incision laparoscopic intragastric surgery (sLIGS), which are both minimally invasive and offers improved cosmetic outcomes, to treat SMT located adjacent to the esophagogastric junction (EGJ)...
August 3, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28762900/-the-problem-of-minimally-changed-coronary-arteries-at-elective-coronary-angiography
#6
A N Sumin, E V Korok, M A Sinkov, O A Nagirnyak, L S Barbarash
AIM: to study rates and possible causes of detecting "clean" coronary arteries at elective coronary angiography. MATERIAL AND METHODS: Medical records of 711 patients who had undergone elective coronary angiography (ECAG) between 01/04 and 31/05 2014 were retrospectively reviewed. Four groups were distinguished: group 1 - patients with normal coronary arteries (n=234), group 2 - patients with coronary artery stenoses (CAS) <60% (n=94), group 3 - patients with 60-69% CAS (n=22), group 4 - patients with CAS more or equal 70% (n=361)...
April 2017: Kardiologiia
https://www.readbyqxmd.com/read/28761401/modified-port-access-technique-for-the-treatment-of-aortic-dissection-after-previous-cardiac-surgery
#7
Edvin Prifti, Aurel Demiraj, Roland Xhaxho
One of the most challenging conditions to manage after previous cardiac surgery is chronic dissection of the ascending aorta. We operated on a 54-year-old man who had aortic dissection in addition to large aortic dimensions very close to the sternum, severe aortic regurgitation, and a false lumen in the descending aorta. We used a combination of perfusion and myocardial protection techniques, arising from port-access technology, that enabled antegrade flow into the aorta, endoclamping of the ascending aorta, the administration of cardioplegic solution before opening the sternum, and left ventricular venting to prevent ventricular distention...
June 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28760476/continuous-procedural-full-lung-ventilation-during-minimally-invasive-coronary-bypass-grafting
#8
Stephan Sixt, Hug Aubin, Robert Kalb, Philipp Rellecke, Artur Lichtenberg, Alexander Albert
BACKGROUND: In the past, minimally invasive cardiac surgery (MICS)- coronary artery bypass graft surgery (CABG) alternatives have been introduced that dramatically reduce the invasiveness of standard operative procedures while still showing excellent clinical outcomes. However, in patients with high morbidity, reduced lung function impeding single-lung ventilation is one of the major concerns for MICS-CABG procedures, although those patients might reap the largest benefit from a procedure of reduced invasiveness...
July 28, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28759544/minimally-invasive-access-aortic-arch-surgery
#9
Nora Goebel, Daniel Bonte, Schahriar Salehi-Gilani, Ragi Nagib, Adrian Ursulescu, Ulrich F W Franke
OBJECTIVE: Median sternotomy is still the standard approach for aortic arch surgery. Minimally invasive techniques promise faster recovery with shorter hospital stay due to thoracic stability, reduced pain, and superior cosmetic results. However, safety is a concern in complex aortic surgery. The aim of our study was to demonstrate that aortic arch surgery via partial upper sternotomy is viable, safe, and equivalent to standard procedure both in terms of its safety and the risk of major adverse cardiac and cerebrovascular events...
July 28, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28755257/two-way-interaction-effects-of-perioperative-complications-on-30-day-mortality-in-general-surgery
#10
Minjae Kim, Guohua Li
BACKGROUND: Multiple perioperative complications increase mortality risk, and certain complications synergistically increase this risk to a greater degree than might be expected if the complications were independent, but these effects are not well established. METHODS: This is a retrospective cohort study of 422,827 intraabdominal general surgery patients (American College of Surgeons National Surgical Quality Improvement Program 2005-2011). Eight complications were evaluated: acute respiratory failure (ARF), acute kidney injury (AKI), sepsis/septic shock, stroke, cardiac arrest (CA), myocardial infarction (MI), deep vein thrombosis/pulmonary embolus, and transfusion...
July 28, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28746233/preoperative-thromboelastometry-for-the-prediction-of-increased-chest-tube-output-in-cardiac-surgery-a-retrospective-study
#11
Waldemar Gozdzik, Barbara Adamik, Grzegorz Wysoczanski, Anna Gozdzik, Maciej Rachwalik, Tomasz Skalec, Andrzej Kübler
Bleeding following cardiac surgery is a serious event with potentially life-threatening consequences. Preoperative recognition of coagulation abnormalities and detection of cardiopulmonary bypass (CPB) related coagulopathy could aid in the start of preventive treatment strategies that minimize perioperative blood loss. Most algorithms that analyze thromboelastometry coagulation tests in elective cardiac surgery do not include test results performed before surgery. We evaluated preoperative rotational thromboelastometry test results for their ability to predict blood loss during and after cardiac surgery...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28744873/epicardial-ablation-of-tachyarrhythmia-in-children-experience-at-two-academic-centers
#12
Shailendra Upadhyay, Edward P Walsh, Frank Cecchin, John K Triedman, Juan Villafane, J Philip Saul
BACKGROUND: Experience with percutaneous epicardial ablation of tachyarrhythmia in pediatrics is limited. This case series addresses the feasibility, safety and complications of the procedure in children. METHODS: A total of 9 patients underwent 10 epicardial ablation procedures from 2002 to 2013 at two academic centers. Activation mapping was performed in all cases, and electro-anatomic map was utilized in 9 of the 10 procedures. Patients had undergone 1-3 failed endocardial catheter ablations in addition to medical management, and all had symptoms, a high-risk accessory pathway (AP), aborted cardiac arrest with Wolff-Parkinson-White syndrome (WPW) or ventricular dysfunction...
July 26, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28740715/minimally-invasive-valve-surgery-in-high-risk-patients
#13
REVIEW
Orlando Santana, Steve Xydas, Roy F Williams, S Howard Wittels, Evin Yucel, Christos G Mihos
The use of minimally, or less invasive, approaches to cardiac valve surgery has increased over the past decade. Because of its less traumatic nature, early studies in lower risk patients demonstrated the approach to be associated with an enhanced recovery, increased patient satisfaction, and good operative outcomes. With time, despite a steep learning curve, surgeons expanded this approach to perform more complex procedures, and include patients with more co-morbidity. The aim of this publication is to review the current literature involving the use of minimally invasive valve surgery (MIVS) in higher-risk patients...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28740710/percutaneous-coronary-intervention-followed-by-minimally-invasive-valve-surgery-compared-with-median-sternotomy-coronary-artery-bypass-graft-and-valve-surgery-in-patients-with-prior-cardiac-surgery
#14
Orlando Santana, Steve Xydas, Roy F Williams, Angelo LaPietra, Maurice Mawad, Jason C Wigley, Nirat Beohar, Christos G Mihos
BACKGROUND: In patients with prior cardiac surgery requiring re-operative coronary and valve surgery, a hybrid approach of percutaneous coronary intervention followed by minimally invasive valve surgery (PCI + MIVS) may be an alternative to the standard median sternotomy coronary artery bypass and valve surgery (CABG + valve). METHODS: The outcomes of patients with prior cardiac surgery, presenting with coronary artery and valvular disease, who underwent PCI + MIVS (N=39) were retrospectively compared with those who underwent CABG + valve (N=28) via a repeat median sternotomy, between February 2009 and April 2014...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28728721/updates-in-minimally-invasive-cardiac-surgery-for-general-surgeons
#15
REVIEW
Muhammad Habib Zubair, John Michael Smith
Significant improvement and development have occurred in minimally invasive cardiac surgery over the past 20 years. Although most studies have consistently demonstrated equivalent or improved outcomes compared with conventional cardiac surgery, with significantly shorter recovery times, adoption continues to be limited. In addition, cost data have been inconsistent. Further ongoing trials are needed to help determine the exact roles for these innovative procedures.
August 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28728711/cardiac-screening-in-the-noncardiac-surgery-patient
#16
REVIEW
Waseem Chaudhry, Mylan C Cohen
This article will address common cardiac conditions that require evaluation prior to noncardiac surgery, characterization of urgency and the risk associated with surgical procedures, calculation of preoperative risk assessment, indications for diagnostic testing to quantify cardiac risk, and perioperative strategies to minimize the risk of cardiac complications.
August 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28714634/-pectus-excavatumn-and-carinatum-in-children-and-adolescents-what-to-say-what-to-do
#17
Pierre Lascombes, Isabelle Ruchonnet-Métrailler, Maurice Beghetti, Armand Bottani, James Wilde
In children presenting with a pectus excavatum (PE) or pectus carinatum (PC) an underlying syndrome including Marfan's syndrome needs to be excluded. In adolescents, severe chest wall deformities may cause cardiac or respiratory problems but most commonly they have a psychological impact. The conservative treatment is a Vacuum Bell for PE, and a Dynamic Compression System for PC ; they play an increasing role in young patients. These devices need to be worn multiple hours per day for several months for an optimal result...
February 15, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28714618/-robotic-cardiac-surgery
#18
Jorge Sierra, Nadia Lahlaidi Sierra, Michel Montessuit, Marek Bednarkiewicz
Cardiac surgery has evolved towards less traumatic procedures. Minimal invasive cardiac surgery is a well-established technic offering patients the same level of excellence accomplished with open surgery. Technological evolution has lead to robotic assistance for minimal invasive cardiac surgery, helping surgeons to perform even better in cardiac repairs or reconstructions.
March 1, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28712580/single-dose-del-nido-cardioplegia-in-minimally-invasive-aortic-valve-surgery
#19
Daniel Ziazadeh, Regina Mater, Ben Himelhoch, Andrew Borgman, Jessica L Parker, Charles L Willekes, Tomasz A Timek
BACKGROUND: The del Nido cardioplegia (DC) procedure offers prolonged cardiac protection with single-dose administration and has proven safe in adult coronary artery bypass grafting (CABG) surgery. We set out to evaluate the efficacy of cardiac protection and clinical outcomes of DC versus standard blood cardioplegia (BC) in minimally invasive aortic valve surgery. METHODS: Between August 2011 and May 2016, 178 patients underwent minimally invasive aortic valve replacement (AVR) with BC (n = 101) or DC (n = 77)...
June 12, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28712172/laparoscopic-sleeve-gastrectomy-a-prospective-follow-up-of-30-patients
#20
Asad Ali Toor, Muhammad Waris Farooka, Mahmood Ayyaz, Zeeshan Razzaq, Awais Amjad Malik, Allah Nawaz, Asif Mahmood, Henry Paul Redmond
BACKGROUND: Morbid obesity has become a surgically treatable problem. Laparoscopic sleeve gastrectomy is becoming a popular choice both for surgeons and patients due to effectiveness and low complication rates. METHODS: It was a prospective case series spanning over 6 years. Patient enrolment started from January 2009 and data collection completed in January 2015. Patient with BMI (weight in kilogram/height in meter square) of more than 35 were included in the study...
January 2017: Journal of Ayub Medical College, Abbottabad: JAMC
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